Basic social services still inaccessible

Tamsir Sall, Ramatoulaye Ngom
Association pour le Développement Economique Social Environnemental du Nord (ADESEN)

The government’s goal of reducing poverty by 30% by 2015 will not be achieved without profound structural changes. The country needs to achieve real and sustained economic growth which will allow such vital aspects as the universalization of education and decent health services to be attained in order to reduce high maternal and child mortality rates.

At the start of the First African Conference on Human Development (Rabat,Morocco, 6 and 7 April 2007), the government of Senegal – a country of over 12million inhabitants composed mainly of young people and women – reiteratedonce again that its goal to reduce poverty to below 30% by 2015 is based on ananticipated annual growth of 7% to 8% in real terms between 2006 and 2010.

The government addedthat the growth of wealth “will be sustained by an increase in public andprivate investment as well as by improvements in the effectiveness of publicexpenditure and an increase of the agricultural sector’s contribution togrowth by means of the diversification and modernization of agriculturalestablishments.”

On a more generalscale and with a view to facing the challenges of poverty and human development,the government decided to revise its Poverty Reduction Strategy (DERPII,2006-2010), based on the priorities established by the Millennium DevelopmentGoals (MDGs) and the strategy for accelerated growth. These priorities include:creation of wealth, development of greater access to basic services and socialsecurity, as well as the prevention and management of risks and disasters, anddecentralized and participative growth.

However, the government’s evaluation is at odds with the 2007 report by theOrganisation for Economic Co-operation and Development (OECD) on the AfricanEconomic Outlook. Bearing the OECD report in mind raises serious questions as tohow the government will be able to achieve the outcomes it seeks in the face ofexisting difficulties.

The OECD report highlights the serious obstacles which prevent theachievement of the poverty reduction goals established by the government, due toa conjunction of unfavourable factors. Those factors, in addition to theircurrent impact, are linked to the vulnerability and structural defects whichcontinue to exist in the country, such as the difficulties regarding theexpansion of exports – for example, in the fields of peanut production,fisheries and phosphates. According to the OECD, they are also a reflection ofthe problems which beset the country in 2006. Whereas growth in 2005 was 5.5%,in 2006 it barely reached 3%. Other sources, however, show a greater increase ofthe gross domestic product (GDP). Such is the case of World DevelopmentIndicators (WDI), whose 2006 report placed the country’s economic growth at6.2%.

One of the problems pointed out in different reports in order to explainthe changes in the rate of economic growth is the possible impact ofinsufficient economic diversification, particularly in a climate “which isstill unfavourable to investment, especially foreign direct investment.”

It is no surprise, therefore, that results in the area of human developmentshould be insufficient and place the country among those with the lowest HumanDevelopment Index (HDI) worldwide (157th place out of 175), although a slightimprovement with respect to 2002 has been recorded.

Massive clandestine emigration

In the face of the failure of agricultural policies, the young see no otherway to escape the inferno of poverty than clandestine emigration. Thus, thecountry has become one of the starting points for massive clandestine emigrationtowards Spain. In 2006, over 31,000 undocumented immigrants, mostly fromSub-Saharan African countries, reached the Canary Islands aboard improvisedcraft, at the risk of their lives. This trend will continue to worsen due to thelack of unemployment insurance and social welfare benefits.

Meanwhile, the prices of articles of prime necessity (oil, rice, bread, sugar,etc.) have soared, which makes the situation even worse. The population alsofaces serious shortages in access to basic services such as water, education andhealth care, sectors which should have been firmly developed in order to lessenthe burden of poverty.

Water, a resource in short supply

The lack of drinking water and adequate sanitation constitute two of the primarycauses of illness and death and also contribute to the country’s lack ofeconomic development. The government has drawn up an ambitious programme withthe aim of implementing improvements in this sector: the Millennium DrinkingWater and Sanitation Programme (PEPAM), a unified intervention plan for thesupply of water and sanitation in urban and rural areas. This programme coversthe years 2005-2015 and attempts to ensure and increase access to drinking waterfor rural and urban households and equip them with adequate independentsanitation systems (waste and sewage disposal), particularly in ruralenvironments. Its main objective is to reduce poverty by helping disadvantagedlocal populations to obtain sustainable access to these basic social services.However, the government’s main concern is to find the financing for investmentin rural hydraulic systems and sanitation for urban and rural environments. Thiswould mean setting aside, in part, the MDGs.

Health: insufficient infrastructure and personnel

In the health area, the report presented at the African Conference on HumanDevelopment points out that indicators are unsatisfactory and that, sadly, theinfant mortality rate is 61 deaths per 1,000 lives births and the childmortality rate is 121 per 1,000.

Other data supplied by UNICEF (2005) show even more distressing figures: themortality rate for children under one year of age is 78 1,000 live births,whereas among children under five years of age it is 137 deaths 1,000 livebirths.

This situation is explained to a large extent by the fact that, in terms ofinfrastructure and personnel dedicated to health care, the country is far fromcomplying with the norms established by the World Health Organization (WHO). Forexample:

The Fatick region in the interior of the country still has no hospital,although construction began before 2000, which means that for over seven years,nothing has been done for the region as regards improving the health conditionsof the population.
The maternity wing of Aristide Le Dantec Hospital in Dakar, the largestin the country, has been closed for almost three years, and no date has been setfor its reopening.
Only a small number of specialist doctors and midwives are trained eachyear.

Although significant progress in the struggle against maternal mortality hasbeen recorded, there is undoubtedly a long way to go in order to achieve theMDGs. Maternal mortality rates should be reduced by 75% between 1990 and 2015.Surveys carried out in 2004 revealed that 690 women still die for every 100,000live births
(UNICEF,2005). Itwas because of this that Dr. Soukeyanatou Fall Kaba sounded the alarm when sherevealed this dramatic situation, in which 48% of women give birth without theattendance of qualified medical personnel. Home births due to socioculturalfactors, difficult access to health care infrastructure and limited financialresources are some of the many reasons which, according to the doctor, explainwhy nobody assumes responsibility for pregnant women.

The MDGs related to health issues will be no more than a dream if the followingmeasures are not adopted:

Good quality health care infrastructure, sufficient in quantity andaccessible to the population.
A real policy for human resources management with definite plans forprofessionalization and an incentive system to train an adequate number ofpersonnel to work immediately and efficiently at all levels of medical care.
A medicine and medical equipment supply system within the EconomicCommunity of West African States (ECOWAS) to guarantee permanent availabilityand a significant reduction in purchase costs for member states, with thesupport of entities such as the West African Health Organization (WAHO) withstrengthened powers and authority.
A flexible and adaptable medical coverage system to enable the greatestpossible number of families to gain access to health care without having to payever-increasing costs (with relation to membership in private healthcareschemes); free medical care for children under five years of age, as well as forwomen during childbirth.
The development of mechanisms to reinforce the power and means of localcommunities and the population in general, through their participation in thefollow-up and control of medical centres, in order to encourage good management.
Reduction of disparity between the different areas of the country bymeans of a suitable policy for the distribution of health infrastructure.

Education: putting the Bamako Statementinto practice

In the field of education, the aim of making primary education universal has notyet been achieved, in spite of an increasing gross rate of enrolment in primaryeducation, from 62% in 1998 to 75.8% in 2003 and 79.9% in 2004. In fact,although adult illiteracy is declining, it still affects 62.2% of thepopulation.
Inthis field, problems are related to a lack of material resources (educationalfacilities, text books) and can be solved by means of budgetary allocations.

Although UNESCO, in its 2005 report, situated Senegal, together with two otherAfrican states, among 10 countries in the world with ambitious plans regardingeducation, there are still great efforts which must be made in order to achievereal progress in education. In this sense, putting the 2007 Bamako Statement onthe Abolition of School Fees into practice will have a positive impact on theeducational system in Africa and in Senegal in particular.

At the conclusion ofthe Bamako Conference (19 to 22 June 2007) organized by the Association for theDevelopment of Education in Africa (ADEA), UNICEF and the World Bank to address“School Fee Abolition:Planning for Quality and Sustainable Financing”, 200 delegates from 23 countries concluded that in thecurrent situation “a considerable number of countries will not reach the targeted goal” as long as universal accessto the first year of primary education cannot be achieved within the next twoyears. In a formal statement, the ministers of education and finance of the 23countries participating in the international conference reiterated theircommitment to improving strategic planning in order to comply with the demandfor universal primary education by 2015. As the report shows, the ministers’commitment is aimed at “doing whatever is necessary so that no child iskept away from school because his family does not have the financial resourcesto send him there.”The Bamako Statement also called on participating governments “to increase resources on thenational level as well as the effectiveness of their use,” “to establishoptimal policies,” and to plan activities that can “guarantee the success ofthe initiative to abolish school fees.”

Thesignatories of the Bamako Statement acknowledge the fact that “our countries, while sharingthe same commitment, are at different stages of achieving this goal.” They recognize that eachcountry “facesdiffering realities, differing challenges, and each will find its own path.” On the other hand, andaware of “therole of civil society in development,” they stated that “we pledge to worktogether to mobilize the support of our citizens whose children’s futuresdepend on the opportunities that free schooling will provide.” It is within theframework of these actions that the ministers intend to “establish effectivemonitoring mechanisms to ensure the commitment to these goals achieves results.” They also request thatthe World Bank and the Group of Eight leading industrialized nations (G8) shouldfulfil their 2005 promise to ensure that “all children have access to complete free andcompulsory primary education of good quality.” They also invite sponsors to “provide financing that ispredictable, that is available over the long term, and that is consistent withour national education plans.


ADEA (Association for theDevelopment of Education in Africa) (2007). “The ministers of education andfinance of 23 countries commit to attaining universal primary education by2015”. Press release, 22 June. Available from:<>.
InternationalConference on School Fee Abolition: Planning for Quality and SustainableFinancing (2007). “The Bamako Statement on the Abolition of School Fees by the Ministers ofEducation and Finance”. 19-22 June, Bamako, Bali. Available from: <>.
UNESCO (2004). EFA Global Monitoring Report 2005. Education for All. TheQuality Imperative. Paris: UNESCO. Available from: <>
UNICEF (2005). The State of the World’s Children 2006. Excluded and Invisible. New York: UNICEF. Available from: <>.